BACKGROUND: The Ectrodactyly-Ectodermal Dysplasia-Clefting (EEC) Syndrome involves abnormalities of the hands and feet, skin and teeth, and clefts of the lip and palate. Patients have abnormalities of facial features, namely clefts of the lip and palate and abnormal dentition, which affect the growth of their midface region. The purpose was to describe characteristics of mid-face growth in patients with EEC. METHODS: A retrospective chart review was conducted for patients seen at CHOP between the years of 1987 and 2004. Surgeon's assessment and cephalometric measurement was analyzed. Comparison was made to Bolton standards for normal facial growth to determine deficiency. RESULTS: All 8 patients displayed mid-face disproportion. Five of the 8 were found to have some degree of mid-face retrusion. The upper anterior facial height was found to be deficient for 50% of the patients. Six patients had deficient lower facial height and 4 patients had deficient total face height. Two have undergone mid-face distraction osteogenesis. CONCLUSIONS: Our study identified a subset of patients within the cleft clinic who carry the diagnosis of EEC syndrome. They tend to have poor dentition which, coupled with clefts of the lip and palate, inhibits normal mid-face growth and may require surgical correction.